Healthcare Provider Details

I. General information

NPI: 1124153036
Provider Name (Legal Business Name): DR. LAMOINE ANN DUGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN DUGAN PSY D

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4772 N WOLVERINE PASS RD
APACHE JUNCTION AZ
85219-8513
US

IV. Provider business mailing address

4772 N WOLVERINE PASS RD
APACHE JUNCTION AZ
85219-8513
US

V. Phone/Fax

Practice location:
  • Phone: 480-288-9845
  • Fax: 480-288-9845
Mailing address:
  • Phone: 480-288-9845
  • Fax: 480-288-9845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: